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Contact Information

BROADWAY CLINIC PHARMACY INC
50 LINCOLN ST
KERMIT, WV25674
 Phone: 304-393-3386
 Fax: 304-393-3387
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for BROADWAY CLINIC PHARMACY INC

NPI Number 1043589062
LBN Legal business name BROADWAY CLINIC PHARMACY INC
Authorized official STEVE WILLIAMS - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 12/20/2011
Last updated 12/20/2011 - About 14 years ago
Identifiers
WV License # MP0552396
Other 5055618 NCPDP PROVIDER IDENTIFICATION NUMBER
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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